Peter Roy-Byrne, MD Medication treatment of anxiety is generally safe and effective. But it often takes time and patience to find the drug that works best for you. Each anxiety disorder has different symptoms. Medication is often used in conjunction with psychotherapy and exercise to treat anxiety. Anxiety disorders are different, though. They are a group of mental illnesses, and the distress they cause can keep you from carrying on with.
Anxiety Medication 2.
Evidence-based online treatments can be as effective as face-to-face treatments. These online treatments are often referred to as e-mental health programs. Psychological therapies have been found to be most effective treatment for anxiety and relapse prevention over the long term. Sometimes, however, medication can be helpful working together with psychological therapies. Research shows that CBT is the most effective treatment for anxiety, and for preventing future anxiety. When we have anxiety, we can have a worried and anxious view about ourselves and the world around us.
These thinking patterns can become so entrenched, that we don't notice errors of judgement caused by thinking in this way. They may also hold us back from recovering. CBT aims to show us how our thinking affects our mood. It teaches us to think in a different way about life, perceived dangers, and stress.
We can challenge our anxious thinking patterns and re-frame the way we think. We can also face stressors rather than avoiding them and learn ways to challenge them. Many e-mental health programs online treatments are based on CBT principles, including myCompass. For more e-mental health programs check out self-help tools and apps. There is good evidence suggesting exposure therapies are effective for post-traumatic stress disorder PTSD , obsessive compulsive disorder OCD , and specific phobias.
Exposure therapies may also be useful for social phobia and panic disorder. Sometimes, exposure therapy is used together with CBT. We may confront our fears in person, or even via virtual reality. Exposure therapy via virtual reality can be very effective in treating specific phobias. It might be virtual exposure to say a spider, a snake, or even a situation — like flying, speaking in public, or being in a lift.
These treatments must always be administered by a highly-trained mental health professional. Some situations can evoke distress and careful management is required. Vulnerability to anxiety and depression can often be traced to aspects of social functioning work, relationships, social roles and personality.
The underlying assumption with interpersonal therapy is that mental health and interpersonal problems are interrelated. The goal of IPT is to help us understand how our vulnerabilities can lead to anxiety and depression, or the risk of developing anxiety in the future. Mindfulness-based cognitive therapy is an approach to treating anxiety adapted from Buddhist meditation principles. It is also useful in preventing the return of anxiety, and for assisting with mood regulation.
Mindfulness is a form of self-awareness training. At the same time, it helps us to not make judgements about whether we like or dislike what we think. Sometimes psychologists use these techniques in one-on-one therapy sessions depending on their training and experience. You can also practice mindfulness at home and in everyday life.
There are also many good mindfulness apps. Mindfulness takes practice, and daily sessions can be entered on the daily mood chart. Positive psychology is an area of psychology that focuses on the conditions that contribute to flourishing or optimal functioning. Positive psychology is not about putting on a happy face all the time. Life can be hard and worry and challenges are inevitable. Scientific research shows that there are some strategies that help us navigate challenges in life more effectively, and enjoy life despite the upsets.
Positive psychology researchers have identified lots of everyday activities that improve wellbeing. There are many good resources on positive psychology in practice. See our fact sheets Positive Psychology and Happiness. Psychotherapy is an extended treatment, usually provided over months or years, where a relationship is built up between the therapist and the patient. The relationship is used to explore aspects of a person's past in great depth and to show how these have led to anxiety.
Understanding the link between past and present gaining insight is thought to resolve the anxiety and make a person less vulnerable to becoming anxious again. Counselling encompasses a broad set of approaches and goals that are essentially aimed at helping us with solving long-standing problems in our family or at work.
It is also helpful in addressing sudden major problems that may trigger anxiety crisis counselling. Narrative therapy is a form of counselling based on understanding the 'stories' that we use to describe our lives. The therapist listens to how we describe our problems as stories, and helps us to consider how the stories may restrict us from overcoming present difficulties.
Narrative therapy sees problems as being separate from people. It helps us recognise the range of skills, beliefs and abilities that we already have but may not recognise that we can apply to problems in our lives. Narrative therapy differs from many therapies in that it puts a major emphasis on identifying our strengths. It examines where we have mastered situations in the past, and therefore seeks to build resilience rather than focus on shortcomings.
Read more about e-mental health options. The Black Dog Institute has developed myCompass , which is effective in treating anxiety and depression.
We are also developing other new apps and tools to help treat anxiety. You can access them on the internet using your smartphone, tablet or computer. The programs can help people experiencing mild-to-moderate depression or anxiety. Some e-mental health tools, such as myCompass , have been found to be as effective in treating mild-to-moderate depression as face-to-face therapies.
These therapies mainly focus on reframing thoughts and changing behaviour. The e-mental health programs we recommend have been researched, developed and tested in Australia. Some psychologists encourage their patients to use e-mental health tools in between face-to-face visits. Your psychologist or mental health professional can use the tools to monitor mood improvement and see which treatments are effective.
OnTrack offers free access to online programs, information, quizzes and advice to support the Australian community in achieving mental and physical health and wellbeing. For more e-mental health treatment programs see seeking help for anxiety. Your doctor should undertake a thorough health check before deciding whether medication is a good option for you.
Taking medication for anxiety must be supervised by a doctor. Your doctor will discuss the risks and benefits, side effects, and how regularly you need check-ups. Your doctor can also advise what treatments can work together with the medication, such as psychotherapy, lifestyle changes e. Many people respond well to lifestyle changes and psychological treatments. These medications are used for very severe anxiety in anxiety types such as panic disorder, generalised anxiety disorder GAD , and social phobia.
Antidepressants were initially developed for treatment of depression but some antidepressants can also have a role in treating anxiety. We know that there are changes in brain chemistry that accompany anxiety, and sometimes antidepressants can address this. If anxiety and depression occur together, antidepressants may be prescribed.
There are many kinds of anti-depressants. Selective serotonin reuptake inhibitors SSRIs and serotonin and noradrenaline reuptake inhibitors SNRIs are medications sometimes used in treating anxiety. Beta blockers are more commonly used for heart and blood pressure issues. They are sometimes used to treat social phobia and anxiety around performance, such as speaking in public.
Evidence suggests they are not an effective long-term solution for anxiety issues. Depending on the type and severity of your anxiety, self-help or alternative therapies could be used alone or in conjunction with psychological treatments or medication. Severe anxiety may not respond to self-help and alternative therapies alone. These can be valuable adjuncts to psychological and physical treatments. Researchers think exercise can be helpful for people with anxiety. We need more studies on the effects of exercise on the full range of anxiety disorders.
Regular exercise may increase the level of brain serotonin, the neurotransmitter involved in regulating mood, sleep, libido, appetite and other functions. Problems in the serotonin pathways of the brain have been linked to depression and anxiety. Regular exercise may alleviate symptoms of anxiety by:.
Exercise does not need to be extremely vigorous to be helpful for anxiety, even a brisk walk each day can be beneficial. Long periods of stress and anxiety may also deplete our bodies of magnesium. Magnesium helps in many processes that go on in our bodies. Vitamin D, B vitamins, omega-3, and omega-6 are all thought to be useful for reducing anxiety. There are many magnesium and vitamin B-rich foods you can try to add to your diet:.
You should talk to your doctor before starting any vitamin and mineral supplements. Try to choose unprocessed, fresh foods whenever possible. There is evidence that omega-3 oils, commonly found in oily fish such as salmon, anchovies, trout, tuna, mackerel and swordfish, play a role in mental wellbeing. This has particularly been in cases of bipolar disorder, but some studies also demonstrate antidepressant properties.
We need more research into the effects of omega-3 on anxiety. There are several lines of evidence that suggest that omega-3 consumption may be associated with mental illnesses.
Research suggests that omega-3 is related to a number of biological processes that have been found to be associated with brain functioning. Note that consuming large amounts of some fish may lead to ingestion of contaminants. You can learn more about this in our Omega-3 and mood disorders fact sheet. There are also several very effective de-arousal strategies that you can practice to help with anxiety, such as:. For more information see St. Relaxation techniques can involve gradual and deliberate muscle relaxation, visualising a calm place, and breathing techniques.
Studies show that relaxation techniques are effective across many types of anxiety including GAD, panic disorder, social phobia and some phobias. You can teach yourself relaxation techniques by looking online, or by seeing a professional. Yoga is an ancient Indian exercise philosophy that provides a gentle form of exercise and stress management. It consists of postures or 'asanas' that are held for a period of time and are often synchronised with the breathing. A number of studies have shown that yoga breathing exercises are beneficial for anxiety and depression.
Massage therapy is believed to be helpful for people with anxiety, although further studies are needed to conclusively demonstrate this. Massage produces chemical changes in the brain that result in a feeling of relaxation, calm and wellbeing. It can help reduce anxiety on the day of the massage and may help in giving some ongoing relief.
Anxiety can sometimes occur on its own, or together with depression during pregnancy and the postnatal time after birth period. Worrying thoughts around the health of your unborn baby or your own health are normal. These concerns usually settle with reassurance from your doctor. About one in seven childbearing women show symptoms of an anxiety disorder. Also, a history of a specific phobia, generalised anxiety disorder GAD , separation anxiety or obsessive compulsive disorder OCD increases the risk of anxiety symptoms in pregnancy and after birth.
Over the years, he says, his anxiety, depression, and hypomanic agitation shifted places, so that typically one would be worse while the others were milder. He reached a crisis point while going through a divorce at age His anxiety exploded, leaving him unable to work full days at his thriving physical therapy business. Higher doses of anti-anxiety medication proved counterproductive, however.
At that point, his depression diagnosis was changed to bipolar disorder and a more appropriate mix of medications reduced his symptoms. Part of the challenge for diagnosis and treatment is that anxiety and bipolar interact in various ways which differ from individual to individual. For example, says Otto, anxiety often causes people to avoid certain situations and experiences, which makes life more stressful and paves the way for depressive symptoms.
Anxiety has such an influence on how a person with bipolar disorder responds to treatment that assessing anxiety is likely to become a standard part of care for bipolar. Schaffer was lead author for a paper on treating patients with both a mood disorder and an anxiety disorder, published in February in the Annals of Clinical Psychiatry.
Rebecca, 35, of Edmonton, Alberta, uses an automotive image to explain how closely her conditions are connected. She has learned that spiraling anxiety immediately affects her sleep, complexion, eating habits and other physical factors. Those red flags signal that her mood is beginning to make a bipolar shift in either direction. The good news, she says: Rebecca was diagnosed with depression at 18 after roommates pointed out her moodiness and self-isolation, then with bipolar after a manic episode three years later.
A psychiatrist she saw cast doubt on the bipolar diagnosis, however, and she muddled along with intermittent therapy and antidepressants. Anxiety symptoms—racing heart, hyperventilating, feeling like the walls were closing in—were explained away as linked to temporary stresses. She sank to a new low at age 31, devastated because her husband wanted to end their marriage. Hospitalized for delusions, she got a definitive diagnosis of bipolar plus a separate anxiety diagnosis.
At first, the double whammy made her feel as if she would never get better. Once her symptoms were under control, coping ideas she had heard previously in therapy began to make sense. She rebuilt her life and became a medical secretary. The right diagnoses were also critical to better mental health for Dave, 60, who lives in Oregon. Panic attacks struck unpredictably, even when a barber cutting his hair tried making small talk. Dave now believes his untreated anxiety triggered his first depressive episode at age 17, when he sat listlessly in his back yard for hours.
Yet during episodes of boundless energy, he opened a bakery, bought a half-dozen Subway franchises, and ran for political office.
He finally got help at age After days curled on the couch, speaking in monotones, he let his wife take him to the hospital. He was diagnosed with depression and prescribed medications that made the down times less deep. Years later, when he read a magazine article about mania, he recognized his fast-talking times when he took big business risks and-felt invincible. Dave shared the information with his doctor, received a bipolar diagnosis and appropriate treatment, and saw his manic moods become less extreme.
And when his son finishes a graduate degree in May, Dave is looking forward to attending the ceremony—a big change from when jostling crowds prompted paralyzing anxiety. You can come out the other side. Just as the symptoms of bipolar and anxiety overlap, so do coping techniques such as adequate sleep, plenty of physical activity, and learning to reshape negative patterns of thought and behavior. Toronto psychiatrist Ayal Schaffer notes that cutting back on caffeine, often recommended for people with bipolar, seems to play an important role in defanging anxiety.
To cope with constant worrying: Mindfulness techniques can help to quiet racing thoughts. To cope with self-limiting behavior: Schaffer recommends a similar approach: Plan at least one activity each day in which you speak to another person, ideally in the morning. Generalized Anxiety Disorder symptoms include worrying very much about everyday things, knowing you worry much more than you should, having trouble controlling the constant worries, not being able to relax, having trouble concentrating, being easily startled, having trouble falling asleep or staying asleep, feeling tired all the time, having a hard time swallowing, trembling or twitching, having to go to the bathroom a lot, being irritable, sweating a lot, feeling light-headed or out of breath; and having headaches, muscle aches, stomach aches or unexplained pains.
Phobias are strong, irrational fear of something that poses little or no actual danger. Being anxious and extremely self-conscious in everyday social situations—such as eating or drinking in front of people—are signs of a social phobia. Panic disorder is indicated by sudden and repeated attacks of fear that last for several minutes or longer. These panic attacks bring a fear of disaster or of losing control even when there is no real danger.
A person may also have a pounding or racing heart, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain or feel hot or a cold chill.
When Bipolar Dances with Anxiety
Therapy and medications are the treatment backbone for anxiety and panic disorders. But you also need to reduce anxiety and stress in your everyday life. A stepped-care model for the management of anxiety is recommended. Australian and UK guidelines list non-drug approaches as initial. Anxiety disorders involve a disproportionate emotional and physical reaction to stressful or even neutral life events and daily living. Treatment.